Negotiating disagreement in picture symbol supported decision making


  • Ulrika Ferm DART Centre for augmentative and alternative communication (AAC) and assistive technology (AT) Sahlgrenska University Hospital
  • Steven Bloch University College London
  • Charlotta Saldert University of Gothenburg





This study explores how meaning is co-constructed and negotiated when couples affected by Parkinson’s disease use a symbol supported decision making process (Talking Mats) to talk about their daily lives. Interaction data from three couples of men with Parkinson’s disease, their female partners and a facilitator were examined using Conversation Analysis (CA). Three negotiation sequences in which the partners disagreed regarding the ability of the person with Parkinson’s disease were used to explore the management of divergent views. Negotiation was an individualized process in which the men with Parkinson’s disease were at risk of not being fully involved. Negative assessment and disagreement were displayed in different ways. Strategies such as the use of pronouns and proper names seemed to play important functions in negotiation. Use of pictures such as with Talking Mats may support the handling of different views but partners need to be aware of the potential difficulties involved.

Author Biographies

Ulrika Ferm, DART Centre for augmentative and alternative communication (AAC) and assistive technology (AT) Sahlgrenska University Hospital

Ulrika Ferm is a speech and language pathologist with a doctorate in linguistics. She is specialized in augmentative and alternative communication and works at DART – Centre for AAC and AT, Sahlgrenska University Hospital, Sweden. Her research interests are activity, participation and communication support for children, adolescents and adults with cognitive and communicative disability. A recent publication included a robot study: Participation and enjoyment in play with a robot between children with cerebral palsy who use AAC and their peers, Augmentative and Alternative Communication, 2015.

Steven Bloch, University College London

Steven Bloch is a senior lecturer in Language and Cognition at University College London. His research focuses on the use of conversation analysis to examine progressive neurological communication disorders in everyday interaction. He is Editor-in Chief of International Journal of Language and Communication Disorders. Recent publications include papers in Augmentative and Alternative Communication, Disability and Rehabilitation and the International Journal of Speech-Language Pathology.

Charlotta Saldert, University of Gothenburg

Charlotta Saldert is a speech and language pathologist with a doctorate in linguistics. She is associate professor at the Institute of Neuroscience and Physiology, University of Gothenburg, Sweden. Her research focus is on pragmatics and conversational interaction in aphasia and other neurogenic communication disorders. Recent publications: An interaction-focused intervention approach to training everyday communication partners: A single case study, Aphasiology, 2015; and Communicative barriers in residential nursing homes from the enrolled nurses’ perspective, International Journal of Nursing Studies, 2015.


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How to Cite

Ferm, U., Bloch, S., & Saldert, C. (2016). Negotiating disagreement in picture symbol supported decision making. Journal of Interactional Research in Communication Disorders, 6(2), 131–156.